One in Four May Have Hidden Prediabetes, Diabetes

By Kristina Fiore, Staff Writer, MedPage Today

About 25 percent of healthy people who underwent a free screening at one hospital in Israel were found to have either dysglycemia or undiagnosed type 2 diabetes. Learn more about diabetes and blood sugar disorders.

About 25% of healthy people who opted into a free
screening at one hospital in Israel were found to have either dysglycemia or
undiagnosed type 2 diabetes,
Mona Boaz, PhD, of E. Wolfson Medical Center in Holon, and colleagues, reported
at the World Congress on Insulin Resistance, Diabetes, and Cardiovascular
Disease meeting.

"It was astounding that more than 20% of
people screened had impaired glucose tolerance, and that another 4% had [type
2] diabetes but they didn't know it," Boaz told MedPage Today.

She added that the screening program was easy and
inexpensive, especially because it was run by unpaid volunteers. Previous
studies have shown that volunteers can be trained to run public diabetes,
dysglycemia, and hypertension screenings.

Given the rising prevalence of obesity,
Boaz said there's an urgent need for diabetes prevention, particularly with
regard to lifestyle intervention and early detection.

So to determine the incidence of dysglycemia and diabetes among non-hospitalized
individuals in a hospital setting, the researchers set up a free screening
station in a central location at their hospital. Trained volunteers measured
height, weight, blood glucose, and blood pressure. Boaz pointed out that none
of the patients were fasting at the time of the screen. Participants were asked
if they'd ever been diagnosed with diabetes.

A total of 1,401 individuals with a mean age of 53
were screened; 228 reported having known diabetes and 136 reported having known
hypertension.

For the screening study, normal blood sugar was
defined as a glucose level of less than 140 mg/dL. Dysglycemia was defined as
140 to 190 mg/dL and diabetes was defined as greater than or equal to 200
mg/dL.

Among the 1,173 patients without known type 2
diabetes, the volunteer screeners found dysglycemia in 21.1% of them, and
detected full-blown type 2 diabetes in 4.3%.

Boaz noted that the numbers suggest the true incidence
of undiagnosed type 2 diabetes and dysglycemia in the Israeli population is
likely an underestimate.

Compared with those who had normal blood sugar
levels, those who were dysglycemic were significantly older, and had
significantly higher blood glucose, body mass index (BMI), and systolic blood
pressure.

Patients who were newly diagnosed with type 2
diabetes had significantly higher blood sugar levels than non-diabetics, but
they didn't differ significantly in terms of age, BMI,
or blood pressure.

Boaz said this is likely a function of the small
number of newly identified diabetes cases.

She cautioned that study did have some limitations.
Participants opted to participate in the screening program, although they did
screen over a thousand people, she told MedPage Today.
Also, screening was done in a hospital setting, which increased the chances
that the patient was there because, "they have a suspicion that something
isn't right [with their health]."

She also noted that the results may be different at
other locations in the community — such as a shopping center —
although, "you'll still have the self-selection."

Boaz added that in other unpublished data, when the
study was repeated in 4,000 patients, the 20% dysglycemia rate was slightly
attenuated to about 17%.

Her group concluded that early detection can
trigger early intervention, and has the potential to ultimately reduce
morbidity and mortality related to diabetes.

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